Therapeutic Exercise

Exercise (purposeful physical activity) is beneficial to people of all age groups ,and the health risks of a sedentary lifestyle are well documented.

Benefits of Physical Exercise

Improved cardiopulmonary function

Reduced blood pressure

Increased muscle tone and strength

Greater physical endurance

Increased lean mass and weight loss

Decreased low-density blood lipids

Improved physical appearance

Increased bone density

Regularity of bowel elimination

Promotion of sleep

Reduced tension and depression

Reduced blood glucose level

Fitness Assessment

Fitness means capacity to exercise. Factors such as a sedentary lifestyle, health problems, compromised muscle and skeletal function, obesity, advanced age, smoking, and high blood pressure can impair a client's fitness and stamina.

Body Composition

Body composition is the amount of body tissue that is lean versus the amount that is fat. Determining factors include anthropometric measurements such as height, weight, body-mass index, skin fold thickness, and mid arm muscle circumference.

 Inactivity without reduced food intake tends to promote obesity.

Vital Signs

Vital signs temperature, pulse rate, respiratory rate, and blood pressure reflect a person's physical status.

 

Fitness Tests

Fitness tests provide an objective measure of a person's current fitness level and potential for safe exercise.

Two methods of fitness testing are a stress electrocardiogram and an ambulatory electrocardiogram. Another is a submaximal fitness test, which is an exercise test that does not stress a person to exhaustion. Examples of submaximal fitness tests include a walk-a-mile test.

Stress Electrocardiogram

A stress electrocardiogram tests electrical conduction through the heart during maximal activity and is performed in an acute care facility or outpatient clinic.

 

An ambulatory electrocardiogram is a continuous recording of heart rate and rhythm during normal activity. It requires the client to wear a device called a Holter monitor for 24 hours.

    

 

Walk-a-Mile Test

The walk-a-mile test, measures the time it takes a person to walk 1 mile. The person is instructed to walk 1 mile on a flat surface as fast as possible. The examiner calculates the time from start to finish and interprets results using the guidelines as picture.

  

 Exercise Prescriptions

The prescription for an exercise program involves determining the person's target heart rate.

Target Heart Rate

Target heart rate means the goal for heart rate during exercise. It is determined by first calculating the person's maximum heart rate (highest limit for heart rate during exercise). Maximum heart rate is calculated by subtracting a person's age from 220.

The target heart rate is 60% to 90% of the maximum heart rate.

Beginners should not exceed 60%, intermediates can exercise at 70% to 75%, and competitive athletes can tolerate 80% to 90% of their maximum heart rate.

Exercising at the target rate for 15 minutes (excluding the warm-up and cool-down periods) three or more times per week strengthens the heart muscle and promotes the use of fat reserves for energy. Exercising beyond the target heart rate reduces endurance by increasing fatigue.

Types of Exercise

The two major types of exercise are:

1- fitness exercise.

2- therapeutic exercise.

 Fitness Exercise

Fitness exercise means physical activity performed by healthy adults. Fitness exercise develops and maintains cardiorespiratory function, muscular strength, and endurance ,The two categories of fitness exercise are isotonic and isometric.

 Isotonic exercise is activity that involves movement and work. The example is aerobic exercise, which involves rhythmically moving all parts of the body at a moderate to slow speed without hindering the ability to breathe. In other words, the person can talk comfortably if the exercise is within his or her level of fitness.

 

Isometric exercise consists of stationary exercises generally performed against a resistive force.

Examples include body building, weight lifting, and less intense activities such as simply contracting and relaxing muscle groups while sitting or standing.

 

 

 

 Therapeutic Exercise

Therapeutic exercise is activity performed by people with health risks or being treated for an existing health problem. Clients perform therapeutic exercise to prevent health-related complications or to restore lost functions.

Active Exercise

Active exercise is therapeutic activity that the client performs independently after proper instruction.

For example, clients who have undergone a mastectomy learn to exercise the arm on the surgical side.

 

Passive Exercise

Passive exercise is therapeutic activity that the client performs with assistance and is provided when a client cannot move one or more parts of the body.

For example, for clients who are comatose or paralyzed from a stroke or spinal injury.

Range-of-Motion Exercises

Range-of-motion (ROM) exercises are therapeutic activities that move the joints. They are performed for the following reasons:

To assess joint flexibility before initiating an exercise program.

To maintain joint mobility and flexibility in inactive clients.

To prevent ankylosis (permanent loss of joint movement).

To stretch joints before performing more strenuous activities.

To evaluate the client's response to a therapeutic exercise program.